Individual
JASON B. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
208 MEDICAL PARK BLVD, BRISTOL, TN 37620-7343
(423) 989-4050
(423) 990-3044
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 989-4050
(423) 990-3044
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36696
TN
Other
Enumeration date
12/21/2005
Last updated
02/06/2019
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